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A novel method for infant multiple breath washout: first report in clinical practice

Shawcross, A; Murray, C; Pike, KC; Horsley, A; (2019) A novel method for infant multiple breath washout: first report in clinical practice. Pediatric Pulmonology , 54 (8) pp. 1284-1290. 10.1002/ppul.24384. Green open access

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Abstract

BACKGROUND: Lung clearance index (LCI), measured using multiple breath inert gas washout (MBW) is a potentially useful test in infants with respiratory disease, particularly cystic fibrosis (CF). Clinical use is limited however by the need for specialist staff and equipment. We have previously described a novel method for infant MBW suitable for use outside of specialist laboratories. This study describes its performance in vivo in infants with CF and healthy controls, including a limited comparison with the respiratory mass spectrometer. METHODS: Children aged <2 years with CF and controls underwent MBW testing on a single occasion. Practical applicability of the system was determined by the number of successful duplicate tests, and within-subject repeatability. RESULTS: 25 children (7 with CF, 18 healthy controls, all sedated with chloral hydrate) attempted MBW. 20 patients (7 with CF) successfully underwent duplicate testing (80% success rate). Mean within-subject coefficient of variation for FRC was 7.2% and for LCI 5.9%. Comparison of LCI with the mass spectrometer was limited . but gave very similar values for LCI and FRC in those patients who underwent technically adequate tests with both methods. CONCLUSION: We have described a new MBW method that is feasible and reproducible in sedated infants. Results fall within the expected range, and well within accuracy limits set by international guidelines. This could provide a more accessible alternative to previously described systems for infant MBW, and overcomes many of the technical challenges inherent in conventional MBW.

Type: Article
Title: A novel method for infant multiple breath washout: first report in clinical practice
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/ppul.24384
Publisher version: https://doi.org/10.1002/ppul.24384
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Infant pulmonary function, multiple breath washout, lung clearance index, cystic fibrosis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10063219
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